Provider Demographics
NPI:1992398150
Name:OWN HOUSE RESIDENTIAL CARE LLC
Entity type:Organization
Organization Name:OWN HOUSE RESIDENTIAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MALUAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MABUR
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:207-312-7870
Mailing Address - Street 1:8 JORDAN DR
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-4046
Mailing Address - Country:US
Mailing Address - Phone:207-312-7870
Mailing Address - Fax:
Practice Address - Street 1:8 JORDAN DR
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-4046
Practice Address - Country:US
Practice Address - Phone:207-312-7870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities